Wednesday, June 25, 2014

How to Handle a Common Hazard: The Needle Stick Injury


The needle stick injury. You know you want to avoid it, and you want your staff members to avoid it this hazard, too. And yet sometimes - accidents can happen. We’re talking about an accidental needle stick, a common occupational hazard. How common? Approximately 295,000 accidental needle stick injuries occur annually, based on an International Health Care Worker Safety Center report. However, the CDC indicates a higher number is likely, as these numbers are based on self-reported incidents. On the whole, needle stick incidents are under-reported.


 Naturally, it’s vital that health care staff experiencing an incident receive immediate attention. The goal, obviously, is to lower the risk of contracting a pathogen, to lower the chances of contracting diseases like HIV or human immunodeficiency virus, Hepatitis C or HCV, and HBV or Hepatitus B.

According to a recent article in The Hospitalist magazine, making a rapid, skilled response to a needle stick injury greatly decreases such disease risks.



Can training staff to avoid needle stick situations help? At MedTrainer, our course offerings are designed to help medical staff do so. And, can proper training help to mitigate adverse affects, should accidents occur? Absolutely. MedTrainer’s program emphasize not just rules and regulations, but practical solutions to accidents.

So let’s take a look at what a healthcare worker should do if a needle stick injury occurs.



First: Wash the area with soap and water. Yes, you can use antiseptic solutions, too, but there is no data that recommends this use as reducing the potential of disease transmission versus the use of soap and water.

Second, seek out care in your facility. Report any sharp related injury to the appropriate person or department. Identify the patient source from the needle stick, to evaluate the potential of disease. Remember, the rate of disease transmission is reduced significantly if post-exposure prophylaxis is employed.



A health care worker receiving a needle stick injury is at greater risk for transmission of disease than with other occupational exposures. Receiving with a deep injury, or one obtained with a device contaminated with blood, or involving a needle that has been placed in a patients vein, increases that hazard.

However, contracting HIV after a needle stick injury is comparatively rare. Following needle stick injury even involving a known HIV-positive patient source, there is a one-year risk of only 0.3%. Naturally this doesn’t mean that needle stick injuries should be taken lightly, and staff should be educated in both the hazards, care of avoiding such an injury, and in regard to treatment and actions following such an incident. But it does mean that staff members affected by needle sticks should not panic.




Hepatitis B virus is more easily spread through needle stick incidents, however, the use of  immunization by healthcare staff has created a significant decline in such infection.

All the same, unless post-exposure preventative measures are employed,  a healthcare worker exposed to the virus through a needle stick has a 6% to 30% risk of becoming infected, with the greatest risk from a patient known to be hepatitis B e antigen-positive. But don’t panic: when administered within one week of injury, multiple doses of hepatitis B immune globulin, otherwise known as HBIG, will protect 75% of exposed health care workers from transmission.

In short, quick action regarding needle stick exposure will dramatically help to prevent such diseases. Cleaning the wound, identifying the patient source and any HIV, HCV or HBV status, and identifying the need for and acting on prophylactic treatment is all key.

At MedTrainer we know that educating healthcare staff is vitally important to promote healthy reactions to needle stick accidents. Learning about seroconversion rates, options for prophylactic treatment and more will assist in fast action and accurate evaluation of risk.

If a source patient is known to be HIV-positive, has a positive rapid HIV test, or if HIV status cannot be quickly determined, prophylactic treatment should be performed, using a two or three drug regimen.

Such treatment, when indicated, should begin ASAP. While most health care workers who receive an accidental needle stick will not develop an infection, it is always important to minimize risk. Receiving the Hepatitis B virus (HBV) series vaccine, cleaning any needle stick immediately, reporting the exposure, testing the source patient’s health status, and if necessary administering the correct prophylactic procedure will greatly reduce the chance of infection.

Healthcare workers who accidentally receive needle stick injuries require immediate identification and attention but with this action are at relatively low risk of disease.

Another aspect of education is proper prevention of needle sticks in the first place. MedTrainer’s educational system is designed to train and prevent costly injuries. One educational tip: preventing the transmission of disease by needle stick injuries is aided greatly by wearing gloves. A majority of injuries occur during the handling of a needle between use and disposal rather than actually during use. Training programs that explain and illustrate care used when dealing with needles and sharps offer a jump in safety in particular where needle discards are concerned. Emphasizing care and caution in handling needles and sharps before and after use is vital, and training programs that do so result in a large jump in staff safety.


Along with proper training and education, and access to safety enhancements such as gloves, making sure staff has proper rest breaks is also key to preventing needle stick injuries. In fact, health care workers had on average been working over fifteen hours before injury, and over fifty percent of these workers indicated that fatigue was a strong component to injury. Long hours without rest breaks are basically a costly accident waiting to happen.

Rest breaks are important to staying alert and relieving the potential for exhaustion.

Another training aspect to stress is to prevent recapping of needles. Emphasizing this point reduces the chance of injury. Many staff members who received injury were, in fact, recapping.



Also vital to stress: reporting needle stick injuries. Recent studies have shown that only about one in four were reported. Without reporting such incidents, prophylactic care is not received, even when clearly indicated.

Yes, needle stick injuries are an occupational hazard. Being educated about proper procedures to prevent such occurrences and how to handle such a situation if it occurs is highly recommended. Prompt treatment of such injuries is vital.

Educating staff on proper procedures should such an accident occur, on disease transmission rates, as well as on careful procedures to avoid needle stick incidents in the first place, are all a part of a healthy, informed staff. And MedTrainer can help you achieve just that.

Thursday, June 19, 2014

Trips, Slips, Falls - and Lawsuits


Trips, slips, and falls can be costly to employees, employers, and patients. And they should be avoided, due to both personal pain and suffering, and a different kind of pain and suffering that can occur when the victim sues. Whether it's an employee or a client who is injured, loss comes in a variety of ways.

A case in point: just a few months ago, a New Jersey customer filed a federal lawsuit against a Pennsylvania Home Depot store - because she was injured after slipping in standing water outside the business. Plaintiff Darleen Cook  suffered a cracked pelvis, herniated disc,  fractured sacrum,  and neck and back pain. She alleged that workers at the store had done absolutely nothing to prevent water from pooling at the store’s entrance on a rainy September day. And she’s seeking  $150,000 in damages.



Couldn’t happen in your practice? But it can. One  moment of inattention, one piece of clutter, one slippery floor. A stumble, trip, slip, or fall - and whether the accident affects a staff member or a client, it can lead to serious injury, serious costs, and even a lawsuit, just like the one filed in New Jersey. A wide variety of conditions and situations set the stage for these workplace accidents.

Naturally, you want to prevent them. But where to start? MedTrainer  can help. We offer the courses you need to train your staff to become aware of and compliant in OSHA standards both federal and state - including rules and regulations designed to prevent slips, trips and falls.

Did you know that per the U.S. Department of Labor, slips, trips and falls cause:

    15 percent of all accidental deaths per year, the second-leading cause behind motor vehicles
    25 percent of all reported injury claims per fiscal year
    More than 95 million lost work days per year

That's significant, and appalling data.

To prevent these situations, you need staff members who are trained and aware. From situations such as the wet surfaces that opened Home Depot up to a law suit, to the use of proper signage and clean up techniques that help staff and patients alike to avoid uneven floors, loose mats, damp or freshly waxed floors to the prevention of clutter, open drawers, loose cords or cables - it all starts with staff members who know what to guard against.



Workplace falls after all cause both pain and suffering, lost time, and the legal pain that can come from lawsuits, and a lack of adherence to OSHA standards. OSHA fines are nothing to brush aside, they can be costly. At MedTrainer we’re geared toward preventing fine assessment and helping you become fully OSHA compliant, and safe.

Statistics show most of the falls that occur in the workplace happen on the same level, not going up or down stairs or from a height. These slips usually happen when there isn’t enough traction between your shoes and the surface you’re walking on. Tripping means losing your balance due to loss of traction, meeting another object, being unaware of cords, loose carpet or mats, and the like. But both situations occur when your feet and the walking surface they’re striding on meet in an unexpected fashion.


Staying clutter free is one of the most important ways to prevent falls and tripping. Clean up spills and indicate any wet areas with signs or cones. Don’t let clutter build up, even if you think it’s safely tucked away beneath a desk. Establishing a system that manages and identifies any risk areas, and encouraging staff members to be compliant with safety procedures are the key elements of preventing a slip or trip safety issue. Let’s look back at that Home Depot incident. Proper signage warning of puddling, and clean up of standing water could’ve prevented a world of trouble for the business, and for the injured plaintiff. Did they know to use these techniques and fail to utilize them? Or did they simply not know? Regardless, somewhere down the line there was a lack of essential training necessary to successfully follow OSHA guidelines.



It’s always important to keep a sharp eye out for areas that will keep your workplace safe.
Slips, trips and falls cause personal injury that can be quite severe. And yet so many of these incidents are completely preventable by following standard precautions and safety measures.

Staying safe at work prevents injury and illness, avoids staff stress, regulatory fines, and the potential for lawsuits. In short, making the workplace safe is vitally important for all aspects of the healthcare professions.

Over 653,000 nurses and other healthcare staffers are injured yearly. There’s a number that truly needs reducing. At MedTrainer, we provide the comprehensive safety training to prevent all types of slips and falls and keep healthcare staff and patients both safe and healthy, as well as adhering to OSHA requirements.



While training in safety and compliance is essential, there are some basic you can use right now to help your hospital, medical, dental, or veterinary practice be safer. First of all, always follow good housekeeping - leaving clutter, cords, or spills around leads to a high incidence of injuries, citations, and increased insurance rates, too. Put together a program to establish cleaning procedures as routine, plan the work, and assign responsibilities for completing it.

Second, eliminate wet or slippery areas - or place proper signage or cones indicating they are present. This includes the parking lots and sidewalk space that caused trouble at Home Depot. Clean up spills quickly.

Third, pay attention to the state of traction on surfaces. Need abrasive strips to prevent slips? Anti-skid paint? Moisture absorbing mats in entrance areas and near sinks?

Fourth, get rid of obstacles. That means clutter, equipment that’s out of place, cords, and cables. Eliminating these hazards is key to preventing trips and falls. Close file drawers, unpack boxes and get rid of the packing material promptly.

Fifth, keep an eye on visibility. Are things well lit? Poor lighting means poor footing. Yes, work areas should be well lit and clean, and it’s also important that staff understand to turn on a light when entering a darkened room, keep light switch areas clean and accessible, repair any cords are switches or fixtures that malfunction, and replace any burnt-out bulbs.
 
It’s also vitally important - and a part of the structured, easy to follow, online training MedTrainer offers - to get staff members on board with these necessary safety and compliance steps. Being in too much of a hurry, or carrying too much at one time can lead to falls. Wearing sunglasses in low-lit areas can contribute, major distractions such as texting or talking on a cell phone...also lead to big problems with on the job injury.

Preventing distractions, instructing staff members, and caring about the workplace environment requires an overall shift in direction for many healthcare offices. It’s a shift that’s worth making: prevent trips, falls, spills and you are preventing injury, fines, work loss, and lawsuits. It’s that simple.



Wednesday, June 11, 2014

Infection Prevention



Can preventing infection really save lives? The short answer is a definitive yes. After all, each
year, the lives of patients are lost due to the spread of infections in hospitals. Staph and other infections attack those with lowered immune systems. Health care workers are taking steps to prevent infection and control the spread of infectious diseases.

Both in and out of a hospital setting, the single most effective way to stop infections from spreading is hand washing. Patients should be encouraged to remind friends and family as well as their health care givers to wash their hands. Other steps are also pretty practical and basic - common sense that you would think more people would simply use by rote, and yet do not.


These steps include covering coughs or sneezes with one’s arm rather than hand, or not at all; keeping up to date on immunizations, and making both tissues and hand sanitizers available and within easy access. In the medical profession, it’s key to use gloves, masks, and protective clothing, as well as to carefully follow guidelines in regard to blood or contaminated items.

To prevent transmittal of communicable diseases in health care settings, infection prevention and control is simply necessary. Following a basic comprehension of disease epidemiology, health care staff should be aware of the risks that can increase patient risk, and the procedures and treatments that can present a fertile situation for infection to exist.


Just how risky is it for patients in terms of requiring an infection associate to health care? It depends on there things: the procedure that’s performed, the patient’s health to begin with, and the type of patient/care received.

And for health care staff? Well, health caregivers should be vaccinated against diseases, and wear proper clothing, such as gloves and masks, know as PPE or personal protective equipment. This specialized sanitary clothing is worn to protect against contact with infectious organisms. It includes respiratory protection. And of course following proper hand hygiene procedures such as hand washing, hand sanitizer, and instructing patients on proper hand hygiene is also vital. Outside and inside the medical setting, proper hand hygiene can eliminate about half of all foodborne illnesses as well as helping to reduce the spread of flus and colds. Injection safety is also an important way to prevent infection.

Let’s take a closer look at what’s known as HAI or Healthcare Associated Infections. These are infections that are acquired when patients are receiving treatment, whether for surgical or medical conditions. They can occur in any setting- doctor’s office, hospital, dentist. Precautions that reduce the possibility of infection are key, whether prevention is taken against transmission due to infection agents from environmental surfaces or from bodily fluids.



Patients should be conscious of infection risks, and be integrated into the process of preventing it whenever possible. How so? Patients who enter the hospital for surgery or receive outpatient surgical treatments, if the procedures are planned for, can lower their risk of infection by stopping smoking if a smoker, losing weight, if obese, and controlling blood sugar if diabetic. High blood sugar causes a noticeable uptick in infection risk. Other precautions should also be followed. For example, if a patient needs hair removed prior to surgery, using electrical clippers or depilatory cream is safer than shaving. Shaving with a razor can lead to infection vulnerability.



Another help is treatment with a prophylactic antibiotic within one hour before surgery - earlier or later administration just simply isn’t as effective as an antibiotic administered at that hour mark. Discontinuing prophylactic antibiotics within 24 hours following surgery is also important. Keeping the antibiotic administration going for a longer period can increase side effects as well as the possibility of antibiotic resistance.

Patients should also be encouraged to wash their hands carefully, and remind doctors, nurses and other medical staff to do so. Skin around any intravenous catheter should be kept clean and dry, as should any dressings on a wound.  Asking friends and relatives not to visit if ill, is also key. While all of these aspects of infectious disease precautions are fairly simple, sometimes these are the techniques that work the best to inhibit disease spread and improve compliance.



There’s that word again, compliance. At MedTrainer, we’re here to help you comply with OSHA standards, with HAI prevention compliance, with all the rules and regulations that can seem onerous at times, but which are, in fact, ways to ensure a healthy, protected medical staff, as well as a health and protected patient.

In regard to HAI, signage is one crucial way to help with compliance and with heath. Signage that reminds workers to wash their hands for twenty seconds, and to use hand sanitizer really help. Placing soap dispensers next to the sink, and hand sanitizers in key locations such as bathrooms, hallways, and patient care facilities improves compliance greatly.

And what about the proper use of hand sanitizer? Is it enough to just use it? It needs to be used correctly. After all the CDC recommends using sanitizer for a full 30 seconds in order to disinfect hands. What, short of a stop watch, is going to help get that full thirty seconds in? Some dispensers now feature a flashing red light that stops only when thirty seconds is up.



MedTrainer can’t provide flashing lights, but we can provide the information about compliance issues such as these that helps to educate, inform, and instill techniques that can help greatly with HAI.

Speaking of hand washing and hand sanitization, even this process can lead to infection through occupational dermatitis, that can cause dry and cracked skin. Moisturizing cream helps.

Beyond hand cleanliness, another basic infection prevention process is cleaning of hospital rooms and examination rooms. Environmental cleanliness means physical cleaning plus disinfection. How to monitor this process? Again education and compliance techniques can help to prevent residual bacteria. Technology is also offering an assistance with super-oxidized water made of electrolyzed sodium hypochlorous acid, distributed through a wand spray device. Non-toxic, it leaves to residue and is non-corosive. When cultures have been taken to test the process on standard high-touch areas, residual bacteria present after standard cleaning dropped from an unpleasant 85% to 31% in HOCL treated areas. The treatment can also be used to prevent not just standard infections, but such severe infections as the methicillin-resistant Staphylococcus aureus (MRSA).



Once out of the medical care setting, of course, patients are still at risk from infections. Before going home, attention to detail about wound or incision site care is important, as is full understanding about to care for such a site at home. It’s still important at home to clean hands before and after caring for a wound. And it’s vital to know the signs of an infection at work, such as redness, pain, fever - all of which should be a signal to patients to call their doctor at once.

Thursday, June 5, 2014

Employee Health and Wellness



Employee health and wellness. What does this mean to you and your employees? Does it mean having physicals, offering easy to access health care? A gym in the office? Posters that encourage taking the stairs over the elevator, the salad over the burger?

Whatever technique you utilize to reach employees and improve their quality of life - and your work place health and productivity, it’s a trend. Real money and even penalties are being utilized as incentives to improve staff health.



After all with high health care costs and employee absenteeism as areas to be avoiding in the workplace, employees are being encouraged greatly to take responsibility for being healthy. This encouragement is a part of an overall education and training program that helps employers stay in compliance in regard to working hours, healthcare for employees, and cost savings. If your staff isn’t healthy, how can they encourage patient health? If staff is unwell, absent, unable to work, or racking up disability claims, that benefits no one. A healthy staff is a happy staff, a regulation-compliant staff, and a staff that helps patients to be healthy and happy too. At MedTrainer, we encourage the nearly 90% of all employers who provide incentives for wellness, such as financial rewards, educational programs, exercise facilities, and more.



So what kind of incentives are popular in the workplace, and which work, and work well? It’s still in the experimental stage - what works better both as an incentive and in terms of the ultimate goal of improving employee health, lowering costs, and supporting employees.

Education and awareness are both crucial elements to help staff health. Offering rewards to complete activities designed to create greater health is key. Such rewards include financial incentives to encourage health program participation, and constructively evaluating health and other factors that make this education so important.

Whether staff members are filling out a questionnaire about medical history, diet and fitness, or participating in  biometric screenings for cholesterol, blood pressure and cancer risks, having participation incentives are key to encouraging large scale participation in such an endeavor. With around 90% of employers offering incentives for wellness, simple implementation is vital to identifying employee risk factors and encouraging healthy behavior. Telling staff about health risks and evaluating behavior may not in and of itself assist health and productivity in the work place but it’s a positive start. Data compiles will help you to assess health care needs in the work place as well as overall employee health.

But naturally, finding out this information isn’t necessarily it’s own reward. In fact, to the contrary, informing staff members about risk and advising them does not always lead to positive action. Often encouragement and incentives are offered to get employees to take action after an assessment. What kind of action?

Participating in  weight-management programs or receiving a preventive screening, participation in physical improvement programs and the like - these are the types of actions many employers reward.

And what kind of incentive? Primarily financial, this type of incentive encourages staff  to change unhealthy behaviors. Although in some cases, such incentives don’t encourage real change, rather they encourage participation in specific programs or activities.

Still it’s a step in the right direction, with the financial cost far below that incurred by work loss or poor health among staff. One healthy behavior can lead to another, with more beneficial tasks and changes leading to greater rewards.

Staff members, MedTrainer finds, enjoy the freedom to choose among many health activities, from fitness classes to diet training and weigh-ins. Hitting important healthy marks regarding levels of cholesterol, blood pressure and weight encourages long term participation in these goals.

Staff will be financially motivated to improve health and well being. The carrot is better than the stick: penalties for poor behavior or lack of participation in wellness programs does not lead to the same positive goals.

In short, outcome based assistance works the best. Employers who bind incentives and penalties to health indicators generally have healthier employees with better work habits, lower blood pressure, cholesterol and body mass.


A new survey by Virgin HealthMiles Inc. and Workforce Management Magazine, suggest some 77% of employees feel such programs improve morale, health, and happiness as well as performance on the job and satisfaction on the job.  It’s all about building a culture of health, which is the jumping off point for employers. Staff members become both more motivated and more productive, going beyond basic wellness to healthier behavior all around. It’s a complex process, building employee wellness and health.

There are, after all, legal issues that must be addressed: employers must provide workers who don't reach health targets an alternative method to earn incentives, and carefully evaluate what type of wellness programs and incentives to offer in the first place. Personalized interventions for example often work best, but it’s a fine line between obtaining optimal health goals and preventing the compromise of privacy.

Held annually, the APA’s Psychologically Healthy Workplace Award highlights employers who offer a broader look at employee well-being. Those organizations that utilize techniques that create a healthier work place find improved work quality and productivity, less absenteeism, less turnover, and over all better customer service ratings. Providing employees with work practices supporting well-being results in better performance for businesses and employees across the board. In the medical profession, patients receive better care, and offer higher satisfaction ratings for their providers.

In short: the road to a successful medical care community, whether we are looking at veterinary, medical, dental, or pharmaceutical care, begins with a work environment that’s health both physically and psychologically.
Of course, it can be a challenge  communicating wellness initiatives to employees. While health and wellness programs keep morale high, and staff healthy, economic responsibilities and the business of any medical practice can make it a steep climb to achieve real results.

But the overwhelming benefits of wellness programs are wide reaching. In fact, staff members often evaluate health and wellness offerings when choosing where to work.

From health care related incentives to mental health and depression programs - which have shown the most growth - to weight management, exercise programs, and educational programs, employee wellness programs and the incentives for employers to offer them and improve both health and performance over all are growing daily.



Making measurable progress in aligning workplace wellness programs with employees’ needs and interests is key to a successful wellness program. And how do you measure success? Well it should be based on improved company culture and health, improved workplace productivity and morale.

How to implement these programs? At MedTrainer, we perceive a number of important steps, including:

-Promoting preventative care, such as flu vaccines, on site.
-Encouraging exercise. Discounted group gym memberships perhaps? Promoting a lunchtime walking club? Offering incentives for exercise charting?
-Educating employees. What kind of education? Meditation? Yoga? Healthy eating, cooking classes? All of these greatly benefit.
 Emphasize education.
- Medical staff notoriously does not discuss employee health benefits. It’s as if staff is expected to already know what is best. Make the time to do care giving for your staff!
-Use incentive based reward programs, based on health markers like healthy body mass or blood sugar. What to reward? Prizes, financial rewards, or simple employee recognition.
-Consider snack or meal options that are healthy in the break room. When your staff gets busy, do you think they’ll find better food fuel with fruit and veggies or candy?
-Pay attention to stress levels. The medical profession is stressful, there can literally be life and death decisions. Don’t let unmanaged stress lead to job dissatisfaction, absences, or mental or physical health issues. Encourage appropriate breaks, offer behavioral resources.
-Provide compensation for or actual programs addressing disease management programs, life coaching, stress management programs.